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In 1998, The Lancet, one of the oldest and most famous medical journals, published a paper in which the author noticed a connection between exposure to the MMR vaccine and the onset of enterocolitis and autism. What should parents know about this paper?

The first issue of The Lancet was issued in 1823. For more than a century, this prestigious journal has published peer-reviewed scientific papers every week, and getting your paper published is not easy at all.

In order to get your paper published by The Lancet, you must be a successful scientist who spent years working on a certain topic. If you fall into this category, the next step is getting to a major scientific breakthrough, or at least some big and important discovery in your field of medical science. The third step is when a group of people — usually older, more successful and, generally speaking, more experienced than you — double or triple check everything that you've done. They pour over the topic you chose, the methods that you used, and the conclusions you came to during your experiment, trying to prove you wrong at every turn.

Only if everything checks out will your work will be published by this journal. So, it is no surprise that the scientific community was shocked by the bold findings of Dr Andrew Jeremy Wakefield in 1998. Dr Wakefield claimed that the vaccine against measles, mumps and rubella — the MMR vaccine — causes autism and some other conditions, and he had facts proving his hypothesis.

The publication

In his paper, Dr Wakefield and his team investigated cases of 12 children who had been showing symptoms of bowel disease. What the team found out is that all 12 of the subjects in this study were exposed to the MMR vaccine. Nine out of 12 were also diagnosed with autism and one subject was diagnosed with psychosis, while the other two had encephalitis. The conclusion was, quote:

"We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers."

The environmental trigger was, supposedly, the MMR vaccine.

The problems

In the following years, Dr Wakefield continued publishing works in smaller papers, in a personal mission to convince people that vaccines aren't safe. Although the subsequent papers were published in lesser-known journals and had little to none evidence for their claims, the story about the (lack of) safety of immunization was widely covered by the media. 

People began doubting the safety of the vaccine while other scientists began doubting the methodology of this study — which isn't that strange, because doubting something is the first step to becoming a scientist. Pretty soon, they found several methodological errors in this paper. 
  • The sample size was way too small to draw any conclusions, let alone to have any statistical significance.
  • Dr Wakefield also didn't include a control group (for example, a group of children who didn't receive the MMR vaccine) so he and his team didn't really have any data they could compare their findings to.
  • And last, but not least, Dr Wakefield ignored one of the main scientific principles, one scientists repeat ad nauseam — that correlation doesn't equal causation. In other words, you can't conclude that two things are related just because they happen at the same time, or one follows the other.

In this particular example, the children did develop some form of autism after receiving the MMR vaccine, but autism is usually diagnosed at the age of four, and it is really hard to notice any type of disorder before the age of two. The first dose of the MMR vaccine is administered when a child is 15 months old, and the second one follows at the age of four. If a child falls on the autism spectrum, this diagnosis is very likely to be made at this same age, regardless of whether the child has received the vaccine. Also, contrary to what Dr Wakefield reported, the sampling wasn't consecutive. The team cherry-picked cases that supported their hypothesis. 

Soon after that, 10 out of 12 members of the team revoked their interpretation of the results, claiming that the data was insufficient to draw a conclusion as bold as the one made. It was later discovered that the whole project was funded by lawyers involved in cases against the companies that produce vaccines. In February 2010. The Lancet completely retracted the controversial paper. 

The aftermath

As of 2010, Andrew Wakefield is no longer a doctor. The UK's General Medical Council revoked his license, as he was found guilty of about 30 charges.

Since the fraudulent paper was published, many studies have been conducted to prove that the MMR vaccine is safe. The newest one, coming from Denmark, included 657451 children born between 1999 and 2010. No connection between the MMR vaccine and the onset of autism disorder has been found.

Despite ample evidence that the vaccine is safe, vaccination rates are dropping, and the number of deaths caused by the measles is rising. In 2010, 110 000 people around the world died from a preventable disease.

In conclusion

Twenty years ago, a paper was published by a fraud whose only goal was to gain financial success and fame. His claims have been disproved many times over the years, but there are still a lot of people who believe in them, resulting in deaths around the world.

If you choose not to vaccinate, you are putting your own children in danger, but also the people around them. Herd immunity is the most important mechanism of fighting infectious diseases. In some people, a vaccine just won't help build the immunity against the disease, as vaccines don't have a 100 percent success rate. Others are too young to get vaccinated, while some have lost immunity against some diseases over the time. Exposing those people to the disease could be a death sentence to them.

Vaccines don't cause autism. To claim so would be an insult to anybody on the autism spectrum, and to the people close to them. And even if vaccinating did cause autism, would you rather see your child on the spectrum, or in a casket?

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